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Prognosis of Primary Liver Cancer Based on LI-RADS Classification with Extracellular Agent-Enhanced MRI
Journal of Hepatocellular Carcinoma ( IF 4.2 ) Pub Date : 2023-03-09 , DOI: 10.2147/jhc.s394840 Yubo Li 1, 2, 3, 4 , Xiaoyan Ni 2, 3, 4 , Xinai Liu 1 , Chun Yang 2, 3, 4 , Yi Wang 2, 4 , Xin Lu 2, 3, 4 , Changwu Zhou 2, 3, 4
Journal of Hepatocellular Carcinoma ( IF 4.2 ) Pub Date : 2023-03-09 , DOI: 10.2147/jhc.s394840 Yubo Li 1, 2, 3, 4 , Xiaoyan Ni 2, 3, 4 , Xinai Liu 1 , Chun Yang 2, 3, 4 , Yi Wang 2, 4 , Xin Lu 2, 3, 4 , Changwu Zhou 2, 3, 4
Affiliation
Objective: The prognostic value of the Liver Imaging Reporting and Data System (LI-RADS) 2018 in differentiating hepatocellular carcinoma (HCC) from other primary liver cancers (PLC) with cirrhosis is unclear. We aim to evaluate the value of LI-RADS 2018 with agent-enhanced MRI in the postoperative prognosis of PLC patients with cirrhosis.
Methods: Between 2016 and 2021, 432 patients with cirrhosis and surgically proven single primary liver cancer were retrospectively evaluated. Two radiologists evaluated the preoperative MRI features independently and assigned each lesion a LI-RADS category. Overall survival (OS), recurrence-free survival (RFS), and their associated factors were evaluated by using the Kaplan-Meier method, Log rank test, and Cox proportional hazards model.
Results: The mean age of 432 patients (239 HCCs, 93 ICCs, and 100 cHCC-CCAs) was 57.27± 10.92 years. The LR-M category showed poorer OS and RFS than the LR-4 or LR-5 category did for all primary liver cancers (P < 0.001 for both), and so did HCCs with tumor size less than 30mm (P =0.003 and P =0.04, respectively). In the multivariable analysis, the LI-RADS category and tumor size > 30 mm had independent correlations with OS and RFS (all P < 0.05). Multivariable Cox analysis identified rim arterial phase hyperenhancement (APHE) as independent determinants of poor OS and RFS in primary liver cancers (all P < 0.05).
Conclusion: The LI-RADS categories can predict the postsurgical prognosis of primary liver cancers independently.
Keywords: hepatocellular carcinoma, magnetic resonance imaging, prognosis, liver cirrhosis
中文翻译：
基于 LI-RADS 分类和细胞外药物增强 MRI 的原发性肝癌预后
目的：肝脏影像报告和数据系统 (LI-RADS) 2018 在区分肝细胞癌 (HCC) 与其他原发性肝癌 (PLC) 伴肝硬化方面的预后价值尚不清楚。我们旨在评估 LI-RADS 2018 与药物增强 MRI 在 PLC 肝硬化患者术后预后中的价值。
方法：回顾性评估 2016 年至 2021 年间 432 例经手术证实为单一原发性肝癌的肝硬化患者。两名放射科医师独立评估术前 MRI 特征，并为每个病变分配一个 LI-RADS 类别。采用 Kaplan-Meier 方法、对数秩检验和 Cox 比例风险模型评估总生存期 (OS)、无复发生存期 (RFS) 及其相关因素。
结果：432 名患者（239 名 HCC、93 名 ICC 和 100 名 cHCC-CCA）的平均年龄为 57.27±10.92 岁。对于所有原发性肝癌，LR-M 类别显示出比 LR-4 或 LR-5 类别更差的 OS 和 RFS（两者 P < 0.001），肿瘤大小小于 30mm 的 HCC 也是如此（P = 0.003 和 P =0.04，分别）。在多变量分析中，LI-RADS 类别和肿瘤大小 > 30 mm 与 OS 和 RFS 具有独立相关性（均 P < 0.05）。多变量 Cox 分析确定边缘动脉期过度增强 (APHE) 是原发性肝癌 OS 和 RFS 差的独立决定因素（所有 P < 0.05）。
结论： LI-RADS分级可以独立预测原发性肝癌的术后预后。
关键词：肝细胞癌 磁共振成像 预后 肝硬化
更新日期：2023-03-09
Methods: Between 2016 and 2021, 432 patients with cirrhosis and surgically proven single primary liver cancer were retrospectively evaluated. Two radiologists evaluated the preoperative MRI features independently and assigned each lesion a LI-RADS category. Overall survival (OS), recurrence-free survival (RFS), and their associated factors were evaluated by using the Kaplan-Meier method, Log rank test, and Cox proportional hazards model.
Results: The mean age of 432 patients (239 HCCs, 93 ICCs, and 100 cHCC-CCAs) was 57.27± 10.92 years. The LR-M category showed poorer OS and RFS than the LR-4 or LR-5 category did for all primary liver cancers (P < 0.001 for both), and so did HCCs with tumor size less than 30mm (P =0.003 and P =0.04, respectively). In the multivariable analysis, the LI-RADS category and tumor size > 30 mm had independent correlations with OS and RFS (all P < 0.05). Multivariable Cox analysis identified rim arterial phase hyperenhancement (APHE) as independent determinants of poor OS and RFS in primary liver cancers (all P < 0.05).
Conclusion: The LI-RADS categories can predict the postsurgical prognosis of primary liver cancers independently.
Keywords: hepatocellular carcinoma, magnetic resonance imaging, prognosis, liver cirrhosis
中文翻译：
基于 LI-RADS 分类和细胞外药物增强 MRI 的原发性肝癌预后
目的：肝脏影像报告和数据系统 (LI-RADS) 2018 在区分肝细胞癌 (HCC) 与其他原发性肝癌 (PLC) 伴肝硬化方面的预后价值尚不清楚。我们旨在评估 LI-RADS 2018 与药物增强 MRI 在 PLC 肝硬化患者术后预后中的价值。
方法：回顾性评估 2016 年至 2021 年间 432 例经手术证实为单一原发性肝癌的肝硬化患者。两名放射科医师独立评估术前 MRI 特征，并为每个病变分配一个 LI-RADS 类别。采用 Kaplan-Meier 方法、对数秩检验和 Cox 比例风险模型评估总生存期 (OS)、无复发生存期 (RFS) 及其相关因素。
结果：432 名患者（239 名 HCC、93 名 ICC 和 100 名 cHCC-CCA）的平均年龄为 57.27±10.92 岁。对于所有原发性肝癌，LR-M 类别显示出比 LR-4 或 LR-5 类别更差的 OS 和 RFS（两者 P < 0.001），肿瘤大小小于 30mm 的 HCC 也是如此（P = 0.003 和 P =0.04，分别）。在多变量分析中，LI-RADS 类别和肿瘤大小 > 30 mm 与 OS 和 RFS 具有独立相关性（均 P < 0.05）。多变量 Cox 分析确定边缘动脉期过度增强 (APHE) 是原发性肝癌 OS 和 RFS 差的独立决定因素（所有 P < 0.05）。
结论： LI-RADS分级可以独立预测原发性肝癌的术后预后。
关键词：肝细胞癌 磁共振成像 预后 肝硬化
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